Egalitarianism in a mental health center: an experiment that failed

A core group of staff hired to open a new community mental health center attempted to employ the concepts of egalitarianism and role-blurring to avoid the rigidity and the strictly hierarchical approach to decision-making that existed in the state hospital where they formerly worked. The new structure permitted no authority figures, and decisions were made by the staff as a group. All staff, including the unit chief--a physician--and the psychologist, social workers, nurses, and attendants, were expected to rotate shifts and interchange jobs. The author discusses the inefficiencies and the lack of direction that resulted, and describes the evolution of a more traditional authoritative structure that enabled staff to proceed toward the goal of quality patient care.